The intersection of food insecurity and health for rural Malawian women at the end of life

Background: One of the poorest countries in the world, Malawi's palliative care system is under-resourced, and one-third of the population is food-insecure. Aims: This study describes the lived experience of female palliative care patients, and their caregivers, and aimed to: (1) analyse their physical, spiritual and mental health needs; and (2) analyse best palliative nursing practice for patients at the end of life. An unexpected finding was the impact of food insecurity on the women and their caregivers. Methods: We conducted interviews with 26 women who at the end of life and 14 of their caregivers. All were participating in a community palliative care programme offered by an AIDS support organisation in Kasungu, Malawi.We used deductive qualitative analysis to organise identified themes using the four pillars of food security: availability, access, utilisation and stability. Findings: All study participants experienced challenges with food security. Conclusions: We offer policy recommendations for palliative care nurses, and other allied health professionals.